Provider Demographics
NPI:1356001929
Name:IVANCIC, MARGARET (LCSWA)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:
Last Name:IVANCIC
Suffix:
Gender:F
Credentials:LCSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1724 QUAIL RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27609-4916
Mailing Address - Country:US
Mailing Address - Phone:828-391-0872
Mailing Address - Fax:
Practice Address - Street 1:300 MEADOWMONT VILLAGE CIR STE 202
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27517-7518
Practice Address - Country:US
Practice Address - Phone:919-843-1657
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-23
Last Update Date:2021-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0146661041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCP014666OtherNC SOCIAL WORK CERTIFICATION AND LICENSE NUMBER